المؤلفون: Messier, Stephen P., Gill, Malia E., Mihalko, Shannon L., Beavers, Daniel P., Queen, Kate, Miller, Gary D., Losina, Elena, Katz, Jeffrey N., Loeser, Richard F., DeVita, Paul, Hunter, David J., Quandt, Sara A., Lyles, Mary F., Hudson, David, Callahan, Leigh F.

المساهمون: National Institute of Arthritis and Musculoskeletal and Skin Diseases

المصدر: Arthritis Care & Research ; volume 76, issue 4, page 503-510 ; ISSN 2151-464X 2151-4658

الوصف: Objective The purpose of this study was to determine whether clinical, health‐related quality of life (HRQL), and gait characteristics in adults with knee osteoarthritis (OA) differed by obesity category. Methods This cross‐sectional analysis of 823 older adults (mean age 64.6 years, SD 7.8 years) with knee OA and overweight or obesity compared clinical, HRQL, and gait outcomes among obesity classifications (overweight or class I, body mass index [BMI] 27.0–34.9; class II, BMI 35.0–39.9; class III BMI ≥40.0). Results Patients with class III obesity had worse Western Ontario McMasters Universities Arthritis Index knee pain (0–20) than the overweight or class I (mean 8.6 vs 7.0; difference 1.5; 95% confidence interval [CI] 1.0–2.1; P < 0.0001) and class II (mean 8.6 vs 7.4; difference 1.1; 95% CI 0.6–1.7; P = 0.0002) obesity groups. The Short Form 36 physical HRQL measure was lower in the class III obesity group compared to the overweight or class I (mean 31.0 vs 37.3; difference −6.2; 95% CI −7.8 to −4.7; P < 0.0001) and class II (mean 31.0 vs 35.0; difference −3.9; 95% CI −5.6 to −2.2; P < 0.0001) obesity groups. The class III obesity group had a base of support (cm) during gait that was wider than that for the overweight or class I (mean 14.0 vs 11.6; difference 3.3; 95% CI 2.6–4.0; P < 0.0001) and class II (mean 14.0 vs 11.6; difference 2.4; 95% CI 1.6–3.2; P < 0.0001) obesity groups. Conclusion Among adults with knee OA, those with class III obesity had significantly higher pain levels and worse physical HRQL and gait characteristics compared to adults with overweight or class I or class II obesity. image

الإتاحة: https://doi.org/10.1002/acr.25265Test

المؤلفون: Roy, Baylee, Knapke, Sara, Pillay‐Smiley, Natasha, Zhang, Xue, Queen, Kate, Sisson, Rebecca

المصدر: Pediatric Blood & Cancer ; volume 71, issue 1 ; ISSN 1545-5009 1545-5017

الوصف: An estimated 8.6% of all pediatric patients with central nervous system tumors (CNSTs) have underlying hereditary cancer predisposition (HCP). Identifying HCP affects risk assessment and medical management options for the patients and their family members. However, there is a lack of consensus on the optimal germline genetic testing (GT) approach for pediatric patients with CNSTs. As a first step in addressing the need for consensus, we surveyed oncology and genetics providers from 47 institutions in professional organizations across the United States. We investigated their current practice (e.g., GT decisions and ordering practices) when assessing pediatric patients with CNSTs for HCP. We received 60 responses from 21 pediatric oncologists, 10 neuro‐oncologists, 28 genetics providers, and one neuro‐oncologist/geneticist. Results demonstrate genetic counselors, followed by oncologists, most often facilitated consent, ordered testing, and selected which test to order. The most ordered test was a multi‐gene panel (60%). Of 18 CNST diagnoses, choroid plexus carcinoma (CPC) was the diagnosis for which most providers (78%) reported they would offer GT. For medulloblastoma, 56% overall reported they would offer GT (64% of genetics providers, 62% of neuro‐oncologists, 20% of pediatric oncologists; p = .050). Findings suggest that even for the CNSTs most commonly known to be associated with HCP regardless of family history, there was variability in providers’ decisions to offer GT. The lack of consensus in GT decisions in our study indicates inconsistencies in the genetics care of pediatric patients with CNSTs, demonstrating a need for consensus guidelines to promote consistent genetics care.

الإتاحة: https://doi.org/10.1002/pbc.30725Test

المؤلفون: Namen, Claire, Mihalko, Shannon L, Beavers, Daniel P, Cox, Phillip, Love, Monica, Newman, Jovita, Callahan, Leigh F, Queen, Kate, Messier, Stephen P, FACSM

المصدر: International Journal of Exercise Science: Conference Proceedings

الوصف: BACKGROUND: Osteoarthritis (OA) is one of the chief forms of arthritis and a major reason for disability among older adults. Weight loss is a non-pharmacologic intervention that may help decrease the effects of OA while improving one’s quality of life. The objective of the I-CAN study was to determine whether the weight-loss maintenance (WLM) intervention had a long lasting impact on self-efficacy, maintained weight loss, and ultimately better clinical outcomes. METHODS: Participants who lost more than 5% of their base body weight in the parent study (Weight Loss and Exercise for Communities with Arthritis in North Carolina), were re-randomized and placed into a WLM or an attention control (AC) group. The WLM intervention was a 6-month facilitated maintenance phase that included exercise, as well as group and individual behavioral sessions grounded in social cognitive theory to increase self-efficacy. The AC group included sessions to provide social interaction and health education. The primary outcome was weight change from baseline to the end of intervention. This treatment effect was estimated using mixed linear models adjusted for site, sex, and baseline values of the outcome. Effect sizes were estimated using Cohen’s d. Additionally, the role played by self-efficacy for maintaining weight loss on one’s own was examined. RESULTS: At the start of I-CAN, the participants (n=104, 79 females, mean age=67 years) had a weight of 85.1 kg (SD 13.9). At the 6-month follow up the WLM group gained back less weight (mean=1.3 kg; 95% CI -0.25, 2.86) compared to the control group who regained at nearly twice the rate (mean=3.5 kg; 95% CI 1.80, 5.11; P=.037). Self-efficacy accounted for 22% of the total effect of the WLM group. Interviews at the end of the intervention suggest that the WLM was well-received, with all participants endorsing the statement “The program had a positive impact on my confidence that I can maintain my weight indefinitely†and one participant commenting that “it is possible to lose ...

العلاقة: https://digitalcommons.wku.edu/ijesab/vol16/iss3/340Test

الإتاحة: https://digitalcommons.wku.edu/ijesab/vol16/iss3/340Test

المؤلفون: Messier, Stephen P., Gill, Malia E., Mihalko, Shannon L., Beavers, Daniel P., Queen, Kate, Miller, Gary D., Losina, Elena, Katz, Jeffrey N., Loeser, Richard F., DeVita, Paul, Hunter, David J., Quandt, Sara A., Lyles, Mary F., Hudson, David, Callahan, Leigh F.

المصدر: Arthritis Care and Research; April 2024, Vol. 76 Issue: 4 p503-510, 8p

مستخلص: The purpose of this study was to determine whether clinical, health‐related quality of life (HRQL), and gait characteristics in adults with knee osteoarthritis (OA) differed by obesity category. This cross‐sectional analysis of 823 older adults (mean age 64.6 years, SD 7.8 years) with knee OA and overweight or obesity compared clinical, HRQL, and gait outcomes among obesity classifications (overweight or class I, body mass index [BMI] 27.0–34.9; class II, BMI 35.0–39.9; class III BMI ≥40.0). Patients with class III obesity had worse Western Ontario McMasters Universities Arthritis Index knee pain (0–20) than the overweight or class I (mean 8.6 vs 7.0; difference 1.5; 95% confidence interval [CI] 1.0–2.1; P< 0.0001) and class II (mean 8.6 vs 7.4; difference 1.1; 95% CI 0.6–1.7; P= 0.0002) obesity groups. The Short Form 36 physical HRQL measure was lower in the class III obesity group compared to the overweight or class I (mean 31.0 vs 37.3; difference −6.2; 95% CI −7.8 to −4.7; P< 0.0001) and class II (mean 31.0 vs 35.0; difference −3.9; 95% CI −5.6 to −2.2; P< 0.0001) obesity groups. The class III obesity group had a base of support (cm) during gait that was wider than that for the overweight or class I (mean 14.0 vs 11.6; difference 3.3; 95% CI 2.6–4.0; P< 0.0001) and class II (mean 14.0 vs 11.6; difference 2.4; 95% CI 1.6–3.2; P< 0.0001) obesity groups. Among adults with knee OA, those with class III obesity had significantly higher pain levels and worse physical HRQL and gait characteristics compared to adults with overweight or class I or class II obesity.

المؤلفون: Roy, Baylee, Knapke, Sara, Pillay-Smiley, Natasha, Xue Zhang, Queen, Kate, Sisson, Rebecca

المصدر: Pediatric Blood & Cancer; Jan2024, Vol. 71 Issue 1, p1-10, 10p

المؤلفون: Messier, Stephen P., Callahan, Leigh F., Beavers, Daniel P., Queen, Kate, Mihalko, Shannon L., Miller, Gary D., Losina, Elena, Katz, Jeffrey N., Loeser, Richard F., Quandt, Sara A., DeVita, Paul, Hunter, David J., Lyles, Mary F., Newman, Jovita, Hackney, Betsy, Jordan, Joanne M.

المساهمون: National Institute of Arthritis and Musculoskeletal and Skin Diseases, General Nutrition Centers

المصدر: BMC Musculoskeletal Disorders ; volume 18, issue 1 ; ISSN 1471-2474

مصطلحات موضوعية: Orthopedics and Sports Medicine, Rheumatology

الإتاحة: https://doi.org/10.1186/s12891-017-1441-4Test

المؤلفون: Messier, Stephen P., Beavers, Daniel P., Queen, Kate, Mihalko, Shannon L., Miller, Gary D., Losina, Elena, Katz, Jeffrey N., Loeser, Richard F., DeVita, Paul, Hunter, David J., Newman, Jovita J., Quandt, Sara A., Lyles, Mary F., Jordan, Joanne M., Callahan, Leigh F.

المصدر: JAMA ; volume 328, issue 22, page 2242 ; ISSN 0098-7484

الوصف: Importance Some weight loss and exercise programs that have been successful in academic center–based trials have not been evaluated in community settings. Objective To determine whether adaptation of a diet and exercise intervention to community settings resulted in a statistically significant reduction in pain, compared with an attention control group, at 18-month follow-up. Design, Setting, and Participants Assessor-blinded randomized clinical trial conducted in community settings in urban and rural counties in North Carolina. Patients were men and women aged 50 years or older with knee osteoarthritis and overweight or obesity (body mass index ≥27). Enrollment (N = 823) occurred between May 2016 and August 2019, with follow-up ending in April 2021. Interventions Patients were randomly assigned to either a diet and exercise intervention (n = 414) or an attention control (n = 409) group for 18 months. Main Outcomes and Measures The primary outcome was the between-group difference in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee pain score (range, 0 [none] to 20 [severe]; minimum clinically important difference, 1.6) over 18 months, tested using a repeated-measures mixed linear model with adjustments for covariates. There were 7 secondary outcomes including body weight. Results Among the 823 randomized patients (mean age, 64.6 years; 637 [77%] women), 658 (80%) completed the trial. At 18-month follow-up, the adjusted mean WOMAC pain score was 5.0 in the diet and exercise group (n = 329) compared with 5.5 in the attention control group (n = 316) (adjusted difference, −0.6; 95% CI, −1.0 to −0.1; P = .02). Of 7 secondary outcomes, 5 were significantly better in the intervention group compared with control. The mean change in unadjusted 18-month body weight for patients with available data was −7.7 kg (8%) in the diet and exercise group (n = 289) and −1.7 kg (2%) in the attention control group (n = 273) (mean difference, −6.0 kg; 95% CI, −7.3 kg to −4.7 kg). There were 169 serious ...

الإتاحة: https://doi.org/10.1001/jama.2022.21893Test
https://jamanetwork.com/journals/jama/articlepdf/2799405/jama_messier_2022_oi_220131_1670262083.82673.pdfTest

المؤلفون: Messier, Stephen P, Callahan, Leigh, Beavers, Daniel P, Queen, Kate, Mihalko, Shannon L, Miller, Gary D, Losina, Elena, Katz, Jeffrey N, Loeser, Richard, Quandt, Sara A, DeVita, Paul, Hunter, David J, Lyles, Mary F, Newman, Jovita, Hackney, Betsy, Jordan, Joanne

الوصف: Background Recently, we determined that in a rigorously monitored environment an intensive diet-induced weight loss of 10% combined with exercise was significantly more effective at reducing pain in men and women with symptomatic knee osteoarthritis (OA) than either intervention alone. Compared to previous long-term weight loss and exercise trials of knee OA, our intensive diet-induced weight loss and exercise intervention was twice as effective at reducing pain intensity. Whether these results can be generalized to less intensively monitored cohorts is unknown. Thus, the policy relevant and clinically important question is: Can we adapt this successful solution to a pervasive public health problem in real-world clinical and community settings? This study aims to develop a systematic, practical, cost-effective diet-induced weight loss and exercise intervention implemented in community settings and to determine its effectiveness in reducing pain and improving other clinical outcomes in persons with knee OA. Methods/Design This is a Phase III, pragmatic, assessor-blinded, randomized controlled trial. Participants will include 820 ambulatory, community-dwelling, overweight and obese (BMI ≥ 27 kg/m2) men and women aged ≥ 50 years who meet the American College of Rheumatology clinical criteria for knee OA. The primary aim is to determine whether a community-based 18-month diet-induced weight loss and exercise intervention based on social cognitive theory and implemented in three North Carolina counties with diverse residential (from urban to rural) and socioeconomic composition significantly decreases knee pain in overweight and obese adults with knee OA relative to a nutrition and health attention control group. Secondary aims will determine whether this intervention improves self-reported function, health-related quality of life, mobility, and is cost-effective. Discussion Many physicians who treat people with knee OA have no practical means to implement weight loss and exercise treatments as recommended ...

العلاقة: https://doi.org/10.17615/3m0m-1q37Test; https://cdr.lib.unc.edu/downloads/2n49t425v?file=thumbnailTest; https://cdr.lib.unc.edu/downloads/2n49t425vTest

الإتاحة: https://doi.org/10.17615/3m0m-1q37Test
https://cdr.lib.unc.edu/downloads/2n49t425v?file=thumbnailTest
https://cdr.lib.unc.edu/downloads/2n49t425vTest

المؤلفون: Queen, Kate, Shaffer, Cherie, Underwood, Mary, Duncan, Robyn

المصدر: Journal of Clinical Densitometry ; volume 15, issue 4, page 480 ; ISSN 1094-6950

مصطلحات موضوعية: Radiology, Nuclear Medicine and imaging, Orthopedics and Sports Medicine, Endocrinology, Diabetes and Metabolism

الإتاحة: https://doi.org/10.1016/j.jocd.2012.08.004Test
https://api.elsevier.com/content/article/PII:S1094695012001278?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1094695012001278?httpAccept=text/plainTest

المؤلفون: Chen, Lan X., Eberhardt, Robert, Enzenauer, Robert J., Horwitz, Harold M., Luk, Andrew J., Melnicoff, Ira, Pepmuellar, Peri H., Queen, Kate T., Ramanujam, Thaila, Straka, Pablo C., Svara, Claudia, Travers, Richard, Wallace, Daniel, Watanabe, Wataru, Weiss, Terry, Schumacher, H. Ralph

المصدر: JCR: Journal of Clinical Rheumatology ; volume 9, issue 4, page 228-238 ; ISSN 1076-1608

الإتاحة: https://doi.org/10.1097/01.rhu.0000081256.86721.d8Test